LUNG INJURY/OCCUPATIONAL INJURY

Question 1

What is sepsis a result of?

Answer 1

Infection that gets so advanced that it causes an inflammatory response that affects the entire body.
OR toxins which are released into the body as a result of biproduct of the infection causing tissue damage to the lungs.

Question 2

What is the most devastating response which can cause multi-organ failure?

Answer 2

Inflammatory response

Question 3

How does inflammatory respond to the infection? How does the brain respond? What is it called when it affects the blood vessels going to the lungs? What does typically end up causing in the lungs?

Answer 3

It releases chemical that destroy tissue.
When this happens in the brain you are less responsive.
When it affects the blood vessels going to the lungs it’s commonly known as ARDS
Causing massive pulmonary edema in the lungs.

Question 4

Is lactacte important? What is the relation to lactate and mortality rate?

Answer 4

Yes, the higher the lactate is the higher the mortality rate is.

Question 5

What does a high lactate marker indicate?

Answer 5

There is hypoxia at a cellular level.

Question 6

What is not chemically reactive and not dissolved by water and is essentially what asbestos is made of?

Answer 6

Silicone Dioxide, it is an incredible stable substance.

Question 7

What is the consistency and structure of Abestos? What makes it different and easy to make its way down the respiratory tract?

Answer 7

Sand, dirt, and tiny needle-like structures
The shape of it is what makes it different.
The tiny needle-like structures are so fine that they find their way down to the respiratory tract.

Question 8

What happens once Asbestos has made its way down to the respiratory tract and into the lungs? What attempt to break it down and what does it cause instead?

Answer 8

The body cannot break them down, macrophages try to break down the asbestos molecules but instead cause inflammation as it is never able to.

Question 9

What indicated the worsening effects of the infection through the patient’s body with sepsis?

Answer 9

Respiratory culture

Question 10

For every hour which passes without giving a patient with sepsis antibiotics what is the relationship increase in mortality rate?

Answer 10

10% for every hour

Question 11

What does sepsis cause in the chemical release?

Answer 11

It causes the release of chemicals throughtou the body that damage the immune system such as the endothelial cells, capillaries, arterioles, venioles.
This in turn leaks fluid into brain, kidneys, lungs causing ARDS.

Question 12

What can sepsis also cause?

Answer 12

ARDS & AKI

Question 13

What is the hemodynamic effect of sepsis?

Answer 13

It dilates the blood vessels, which increases blood volume and causes blood leakage, which decreases blood volume, and demand for blood increases and goes to the lungs.

Question 14

What are the treatments for sepsis?

Answer 14

Antibiotics and diuretics

Question 15

How far can Abestos reach? How does it affect the state of the lungs?

Answer 15

It reaches the lower lobes
Causes scarring to the lungs and reduces lung ability to receive oxygen

Question 16

How do macrophages in the lungs attempt to treat the lung from Abestos?

Answer 16

They try to engulf the small bits of silicone dioxide to help treat the lung.

Question 17

What is the blood pressure manifestation of sepsis? And why?

Answer 17

Low blood pressure due to inflammation causing vasodilation which requires more blood supply to the heart.

Question 18

With ARDS secondary to sepsis what is our main priority?

Answer 18

Keeping the patient alive for enough time to allow the body to heal itself.

Question 19

While inflammation is causing vessels to dilate (leading to low BP), therefore more blood is needed to supply the heart, simultaneously fluids are leaking out of the blood through the capillaries, therefore how much initial fluid bolus is needed?

Answer 19

30 mL/kg

Question 20

What is the very first line of tx to begin as soon as possible in septic patients?

Answer 20

Antibiotics and fluids

Question 21

Why is lactate dumped into the body be cells? What is a worsening effect of lactic acidosis mean?

Answer 21

The signal that cells do not have oxygen and are working in an anaerobic environment.
Worsing of lactic acidosis equals worsening of septic shock and therefore higher chance of mortality.

Question 22

When was asbestos product usage banned? How many years does post-exposure manifest any signs?

Answer 22

1971
30 years

Question 23

What are some chronic effects of asbestosis?

Answer 23

Cough and chest pain

Question 24

How is the pleural lining effected by absestosis? What can the worsening of the condition on the pleural lining result in?

Answer 24

Inflamed, and plaque builds up, restricting breathing.
The condition may progress and create mesothelioma, cancer of the pleural lining.

Question 25

At what age does the risk of lung injuries go up especially due to prior work exposure?

Answer 25

70 years old

Question 26

What effects from lung tissue scarring will cause a patient exposed to asbestos to be more susceptible to lung injury?

Answer 26

Loss of elasticity

Question 27

What could have been a cause of the sepsis in the patient with cancer hx undergoing tx?

Answer 27

Central line placement

Question 28

What can lead to shock seen in lactate?

Answer 28

Lactic acidosis

Question 29

What is a sign that someone has fluid overload?

Answer 29

Swollen azygos vein

Question 30

What is another name for coccidioidomycosis?
What is it?

Answer 30

“Valley fever”
It is a dimorphic fungi living in barrel soil areas of the desert

Question 31

What occurs once coccidioidomycosis enters the body?

Answer 31

Grows in the form of year

Question 32

What is the likelihood to be exposed to coccidioidomycosis while living in the desert area and what are the effects?

Answer 32

Most people who live in the areas where it is will inhale it at some point but it will not cause problems usually you will just feel as though you have a cold/flu.

Question 33

What is the treatment for coccidioidomycosis?

Answer 33

fluconazole -an anti-fungal medication

Question 34

What occurs in the citric acid cycle which results in the formation of lactate cells?

Answer 34

The improper role of glycolysis to be transformed accordingly.

Question 35

*What is sepsis?

Answer 35

When the body works so hard to fight an infection that it over-activates the immune system.

Question 36

*What does the inflammatory response to sepsis do to tissues and organs?

Answer 36

it harms them

Question 37

*What is an uncontained hematologic system made up of?

Answer 37

Red blood cells
white blood cells
Platelets
Fluid phase elements

Question 38

*What is the uncontained hematological system of fluid phase elements include?

Answer 38

coagulation factors
natural antithrombotic,
proteins of the fibrinolytic system

Question 39

*What can be a cause of the uncontained hematological system affected due to sepsis

Answer 39

Anemia
Leukocytosis
Thrombocytopenia
Hemostatic system activation

Question 40

*What can the dysfunction of hematologic organ system contribute to?

Answer 40

Multiorgan dysfunction
Death

Question 41

*What does the inflammatory response cause?

Answer 41

-Leaky bloody vessels
-Major organs to lose O2 and nutrients

Question 42

*What should the initial sepsis tx include as a result of leaky blood vessels?

Answer 42

At least 30 ml/kg of fluid followed by

Question 43

*Since it is important to know where the infection originated by what should do to figure it out?

Answer 43

-Getting blood cultures
-Starting empiric broad-spectrum therapy w/ one or more antimicrobials to cover all likely pathogens.

Question 44

*What must be closely watched in patients with sepsis? And what can be a result of elevation?

Answer 44

Lactate levels
Lactate elevation in sepsis is due to increased production of insufficient O2 delivery to the electron transport chain in the mitochondria.

Question 45

*Where is valley fever found? and what is it caused by?

Answer 45

Lives in the soil in the southwestern United States and parts of Mexico and Central and South America.
Fungus coccidiosis

Question 46

*What is the most common way to get valley fever?

Answer 46

Inhaling Coccidiosis spores that are in the air, but in most cases, the individuals that inhale coccidiosis aren’t affected.
However, those with a compromised immune system will develop a fungal infection.